CAM Birth Story #16: Mikella's Birth

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In honor of Cesarean Awareness Month 2010, we will be filling the blogosphere with stories from real women (and their families) who know first-hand the consequences of a 32% cesarean rate. Each day we will post at least one birth story submitted by these women. Prepare to be moved (hint: grab a box of Kleenex)!

From Sarah…

My first C-section was in Sept. 2006. I was induced at 36 weeks and 6 days for Severe Preeclampsia. Around 34 weeks I woke up and found my face puffy and that I gained 11 lbs. in a week. My blood pressure was high and I had protein in my urine, I’m sure not helped by the fact I only had 1 kidney. Despite staying on strict bed rest, my blood pressure continued to rise and the protein in my urine reached a point that I needed to be delivered immediately. The induction failed and ended in a C-section.

During my next pregnancy, I sought out an OB supportive of VBACs and also saw a Homebirth Midwife, who agreed to be with me at the hospital. I should mention, I was not considered a good VBAC candidate. Along with having the Failure to Progress diagnosis and PE history, I also was found to have a unicornate uterus, meaning my uterus is smaller than most, due to a congenital birth defect. However, my OB said there was no reason I couldn’t try for a VBAC.

It was a little nerve wracking towards the end of the pregnancy, since although I never got a diagnosis of PE or Preeclampsia, I felt like my body was teetering on the edge of that and to say I was swollen does not even begin to describe it. I was also seeing a chiropractor trained in the Webster technique. I had several ultrasounds at the end of the pregnancy, and each time my baby was in perfect OA position. I had been having lots of contractions. When checked by my Homebirth Midwife at an appointment about 38 weeks, I was 50% effaced and 2 cm dilated. I continued to have lots of contractions in the next week and welcomed them thinking that meant I was making further progress. At almost 40 weeks, tired of the contractions and worried about the blood pressure and swelling, I went back to the Chiropractor who had offered to do some acupuncture for the purpose of induction. I was reassured it couldn’t put my body into labor if it wasn’t ready, so I figured I’d try. I absolutely hate needles and the acupuncture was NOT fun for me. At the time I decided I wasn’t coming back again if it didn’t work. I went home and didn’t notice anything, so I went to bed.

I woke up a little after midnight with a horrible backache. I got up and took a shower but it didn’t seem to help. The backache reminded me of my back labor with my first (probably OP) baby, but it didn’t come and go as a contraction, it just HURT! I began crying out of frustration and finally woke my husband. By about 3:30 in the morning the back pain start coming and going in waves and at that point seemed to be more like contractions and my husband started timing them. We called the Midwife and she suggested we go to the hospital as she was concerned that I wasn’t feeling a lot of fetal movement and that the labor started oddly, with the prolonged backache. We dropped my older daughter off at a friend’s house and drove to the hospital. At this point, I was so excited. My hope was to just go into labor on my own and be “like a normal person” just going to the hospital in the middle of the night, and I was! I think we got to the hospital around 6 am. They checked me when I arrived and I was about the same as I had been the previous Sat., 2 cm and 60% effaced. They checked us in and ran a strip with the fetal monitor which was normal. The nurse noted my contractions weren’t real close together but also noted I seemed to be in a lot of pain! The nurse we had was not going to be good for me, but seeing as she was going off in less than an hour, I simply had my husband put in a request for a “natural birth friendly” nurse for the next shift. My OB was also coming on call at 7 that morning as well! I should mention here the OB had just gotten back from maternity leave herself, so we hadn’t met or talked in a couple months.

At this point my husband and I walked and waited for the midwife to arrive. I was monitored about 20 minutes out of an hour externally. I think this was because I wasn’t considered to be in “active labor” yet. I took a shower, walked some more, basically labored. I had an awesome nurse who was so supportive. She wasn’t normally on the schedule, but got called in that day because they were so busy. She was such a blessing to have! After a few hours of no progress, my OB offered to break my water. I declined. A while later (about noon) with still not much progress, OB again offered to break waters. At this point I was frustrated with the pain and lack of progress, but I was hesitant to break my water as I had heard it could be easier for babies to rotate with the water intact. At my request, the OB did a quick ultrasound to verify baby’s position and she was ROP. I declined again, and my OB was fine with that. OB was encouraging me that just because this part was taking awhile that didn’t mean that was how the whole labor would go. She also encouraged me that OP babies do come out, even if she never turned. No other words about “speeding things up”. This was very reassuring to me!

So things continued til about 1:30, over 10 hours of back labor. At this point the pain was worsening and I began asking for drugs. Everyone, even my nurse who was very natural birth minded, encouraged me to push through it. I took a bath and lasted til 3:30. At that point, I hadn’t really progressed and couldn’t take the pain anymore. My midwife encouraged me to think about options as I couldn’t go on like this forever. I finally agreed for them to break my water, but I didn’t want my waters broken til I had some pain meds. It was assumed that breaking the water would make the contractions worse and I thought that would put me over the edge! They put in an order for an ISN. (It’s a spinal med with budicaine in it that helps with the back labor). I had it with my last and knew it made the back pain better. The upside of the ISN is I could still move, do hands and knees, feel to push, etc. When they called the Anesthesiologist he actually quizzed the nurse about why I wanted the ISN over an epidural! They even argued for a few minutes about it! This was 3:30. Supposedly the anesthesiologist had to do an epidural before my ISN, which takes a lot longer. At this point I’m just screaming for the drug and had pretty much lost any coping ability I had. At 4 pm my water broke on it’s own and the contractions came faster and hurt worse and still no pain meds. in sight. I was on my hands and knees in a position the midwife swore would help the baby to turn, but doing the position correctly made the pain even worse. The weirdest part of this was that I felt a horrible urge to push with each contraction and I was only 4 cm! The nurse and midwife kept telling me not to and warned me it would make things worse. I told them it wasn’t a choice….I had to push!!! It was horrible and just not controllable. The anesthesiologist finally came over an hour after being called to give me the ISN. At this point I had to go on continuous external monitoring. Evidently at some point, one nurse questioned whether I would be able to have a vaginal birth due to my uterus, but I never heard them say it.

The ISN took effect quickly and my plan was to relax for a little bit (half hour or hour I thought) and then planned to work more on turning baby. I ate a slushy for a bit of energy and tried to rest. Nurse checked me at 5 pm, a half hour after getting the ISN and I was 7 cm and LOA! Her head was finally engaged and I was 100% effaced! It was only another hour and I was ready to push. I pushed for 57 minutes, most of it on my hands and knees leaning against the back of the bed. They let me push as I wished. I laughed as they called the OB in and the nurse told her “She’s on her hands and knees…” like this is really weird 🙂 I eventually turned over and was pushing on my side, with my husband supporting my leg. The nurse asked my OB about breaking the bed apart, etc. and OB said “She’s doing great like this” and she had a seat on the floor. We have a great picture of my OB sitting on the floor with her head in her hand just watching me pushing. Everything seemed so calm at that point only 2 nurses and my OB, no one was saying a thing. I did have to put some oxygen on as baby’s heart rate wasn’t doing the best. The last few pushes they encouraged me to sit up a bit more and baby was out. There had been some meconium when the waters broke so they suctioned her at the perineum and then one more push and she was out. They put her to my chest right away. At this point, I, my husband, and my midwife were all crying. I was so happy! I did have a little tearing, but not bad. They cleaned and checked her on my chest and she latched on and breastfed like a natural! She was blue at birth, and after we had some bonding time, the nurse took her and gave her some oxygen.

The best part of my labor was I didn’t have to fight for anything. My midwife asked a couple times if VBACs were common here and nurses emphatically said no, although they said the practice I was with had many more than the other that had privileges at the hospital. The staff was always so surprised to hear I had a VBAC but very excited for me as well. My wishes were pretty much followed which was amazing as my OB had just returned from maternity leave and we never actually got to discuss my labor wishes 🙂

As a last side note, we did finally find out, 3 weeks after the birth, why I often felt decreased fetal movements and why she was blue at birth and her heart rate dropped during birth. My baby was born with a rare congenital heart defect called TAPVR, and required immediate surgery and a couple long hospital stays. It took 3 weeks for her to be diagnosed. At birth, my OB mentioned to me that she didn’t look right and we could do an Echo, just to be sure her heart was OK. We brought it up to the Pediatrician on call, who dismissed us and told us she was “fine”. We should have pushed harder, as my poor baby crashed and couldn’t breathe on her own just 6 hours after we had arrived at the U of M Children’s Hospital. Her website is here www.caringbridge.org/visit/mikellaruley After the trauma we had to go through and having to be separated from her for so long during the heart surgeries, it meant the world to me that her birth was “normal” and we got to have that special bonding time right away. I was able to focus on my baby during the birth this time, and not on recovering from surgery!

Originally posted on ICAN Twin Cities website.

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